Managing patients with endocrine dysfunction during COVID-19: Review of literatures

Patro Pm,Rao Kvj

doi:10.17727/jmsr.2020/8s1-11

Abstract

Coronavirus disease (COVID-19), caused by the severe acute respiratory distress syndrome. Coronavirus 2 (SARS-CoV-2) is labeled as a global pandemic by the World Health Organization (WHO) on 12th March 2020, is sweeping across the world. There has been documented evidence from China that those patients who have endocrinological disorders face additional risks from COVID-19. Healthcare professionals consider people with diabetes are at higher risk of severe illness. As such people with diabetes are not more likely to get COVID-19 than the general population, but they experience severe symptoms, complications and worse outcome even death, once infected. Hence specific measures are advised for the diabetic patients. The same goes for people with autoimmune conditions that lead to adrenal insufficiency. There may be primary (Addison’s disease), secondary or tertiary adrenal insufficiency in some patients. They regulate the blood pressure, the immune response and body’s stress response. However, nearly 5% of the population takes long-term steroids for inflammatory conditions like bronchial asthma, inflammatory bowel diseases etc.; out of which many would have some degree of insufficient adrenal response in a crisis. As it relates to COVID-19, any such patient who has been on long term corticosteroid therapy; with a dry continuous cough, breathing difficulty and fever should immediately double their daily oral steroid dose and continue this regimen until the fever has subsided. It is recommended for people with adrenal insufficiency. Apart from that, they should seek immediate medical help to avoid complications. Keywords: COVID-19; diabetes; endocrinological disorders; SARS-CoV-2

Highlights

During the coronavirus disease (COVID-19) pandemic, a series of recommendations have recently been published by endocrinologists for people with diabetes, and other hormone disorders
An Italian anatomical pathologist reports that the Pergamo hospital made a total of 50 autopsies, Milan 20; the Chinese have only made 3, which seems to fully confirm the information that, patients who died from COVID-19, it is not pneumonia, because the virus does not kill pneumocytes of its type only but uses an inflammatory storm to create an endothelial vascular thrombosis, with the corresponding diffuse thrombosis the lung is the most affected because it is the most inflamed, and, it produces a heart attack or stroke, and many other thrombotic diseases
It is recommended that people taking glucocorticoids who develop symptoms of COVID-19 should immediately double their daily dose

Summary

Introduction

During the coronavirus disease (COVID-19) pandemic, a series of recommendations have recently been published by endocrinologists for people with diabetes, and other hormone disorders. These patients need special attention to prevent adverse events. COVID-19, caused by the Severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) and labeled as a global pandemic by the World Health Organization (WHO) on 12th March 2020, is sweeping across the globe, even though it started first in China in December 2019. Journal of Medical and Scientific Research “There is early evidence from China that those patients who have endocrinological disorders face additional risks from COVID-19. Paul Stewart, a Professor of Medicine at the University of Leeds in the United Kingdom [1]

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